This invention relates to an abdominal surgical retractor.
The use of devices for retaining and preventing movement of the viscera, or organs, adjoining the field of an abdominal surgical procedure is common surgical practice. Such retaining devices include pads such as towels or large sponges. Another retaining device is the Weinstein retractor, which is a curved metal dam that includes two flat curved metal dam portions slidably joined together by a buckle so that one dam portion can slide along the other dam portion and the two dam portions secured at the buckle at a selected position adapted to the particular abdominal cavity.
During abdominal surgery blood must be removed from the abdominal cavity, a procedure that is done by a surgical assistant or assistants. The abdominal blood is either absorbed by blood absorbing pads or removed from the abdominal cavity by a blood suction apparatus such as a Solcotrans (trade name). Such blood can be salvaged by squeezing the towels into a container or directing suctioned blood into a container. It is highly advantageous to return the salvaged blood back to the patient, either during the operation or later, since the use of the patient's own blood is far preferable than the use of blood from a bank, since contamination of such banked blood by such diseases as AIDS and hepatitis is always a possibility, even though uncommon.
A relatively new abdominal retractor device is a disposable abdominal retracting pad known by the trade name DISARP. This retractor comprises a flexible flat metal rod enclosed in urethane plastic foam in turn wrapped in woven nylon. The metal rod is made of a metal that has no memory and yet has the strength to retain the position to which it is moved. The device is of sufficient bulk and strength to hold back the adjoining viscera during an abdominal surgical procedure. The DISARP device enables the surgical assistant to have one or both hands free during an operation so that he can take a more active part in the operation than with the use of other types of retractor devices. The metallic rod is capable of detection by X-ray, although not having the radioopacity of the magnitude that would disturb an intraoperative cholangiogram. This device has been successfully used in both laparotomies and thoracotomies and combinations thereof. The laparotomies have included cholecystectomies, proctocolectomies, colonic resections, aorto-iliac reconstructions, gastric resections, and pelvis operations.
A serious disadvantage of the DISARP device is that it absorbs the patient's blood in the manner of padding such as towels and sponges. This is because the woven nylon wrapping does not seal the plastic foam that encloses the metallic rod and because the plastic foam is made of polyurethane, an open-celled, thus absorbent, foam. Also, polyurethane contains residual cyanide, pyrogens, and other reactive or irritating elements that should not be mixed with reusable blood. The combination of these factors results in a considerable amount of blood being absorbed by the DISARP device, which blood is not reusable and so is lost to the patient.